Individual
BROOKE RANDOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, AGCNS-BC
Contact information
Practice address
2200 RANDALLIA DR, FORT WAYNE, IN 46805-4638
(260) 373-6070
(260) 373-6704
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
28195468A
IN
Other
Enumeration date
07/28/2022
Last updated
06/03/2024
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